Cognitive decline occurs in both men and women during andropause and menopause, respectively. Testosterone treatment is used to prevent cognitive decline in men with andropause, but no treatment is currently used or recommended to prevent cognitive decline in women with menopause. This is a major unmet clinical need for half of the population, and the need for therapy becomes more urgent as life expectancy increases. Testosterone is not preferred in women due to masculinizing side effects, and it has not been approved to preserve cognition in women. Hormone replacement for menopausal women generally involves treatment with estradiol, conjugated equine estrogens (CEE), or Premarin. These therapies, however, are associated with an increased risk of breast and uterine cancer as well as a cardiovascular risk, and thus they are either not recommended or are recommended only for short treatment durations to manage menopausal symptoms such as hot flushes and sweats. Thus, there remains a need for long-term treatments to reduce the progression of cognitive decline in women with menopause.